Sleep is essential for good health. Poor sleep quality, or not enough sleep, can negatively affect our mood, cognitive function, and immune system.
Stress can impact our sleep, and stress and anxiety associated with the COVID pandemic have meant many of us are not sleeping as well as we used to. A survey of 2,555 people across 63 countries found 47% of people were experiencing poorer sleep than usual during the pandemic, compared with 25% before COVID hit.
We also know stress is associated with poor dietary habits. People who are feeling stressed and tired may be more likely to reach for energy drinks and caffeinated beverages. But a high intake of caffeine as well as sugar-sweetened and energy drinks can keep us awake. So it’s something of a vicious cycle.
Studies have shown chamomile (consumed in the form of an extract or a tea) leads to significant improvement in sleep quality.
However, although the evidence is positive, these studies were relatively small and we need larger, well-designed clinical trials to reinforce these observations.
A warm cup of cow’s milk is a popular bedtime beverage in Western cultures, particularly for children.
Milk is a source of the essential amino acid tryptophan, which our bodies need to produce compounds including serotonin and melatonin in the brain. These compounds are involved in the sleep-wake cycle, which could explain why milk helps us sleep better — if indeed it does.
Scientists have studied the effects of milk and milk products (such as yogurt and cheese) on sleep quality for decades, but the evidence is still inconclusive.
It may simply be the ritual of drinking warm milk before bedtime that relaxes the brain and body, rather than the effects of compounds present in the milk itself. We’ll need more research evidence before we can be confident one way or the other.
There’s limited research on the effects of cocoa on sleep quality. But a study in mice suggested natural cocoa may improve stress-induced insomnia.
In humans, consuming cocoa is associated with a reduction in blood pressure (in healthy people and those with high blood pressure). This lowering of blood pressure, which relaxes the smooth muscles that line our arteries, could produce a calming effect, making it easier to go to sleep.
While these sleep remedies are unlikely to be harmful, the overall evidence on improvement in quality of sleep is weak. You may like to try them, but you shouldn’t see any of them as a quick fix.
At the end of the day, several lifestyle factors can influence our sleep quality, including screen time, physical activity, stress and diet.
If you are consistently struggling to sleep, it’s best to consult with your general practitioner.
A lot has happened over the past year, so you can be forgiven for not having a clear memory of what some of the major concerns were at the beginning of the pandemic.
However, if you think back to the beginning of the pandemic, one of the major concerns was the role that surfaces played in the transmission of the virus.
As an epidemiologist, I remember spending countless hours responding to media requests answering questions along the lines of whether we should be washing the outside of food cans or disinfecting our mail.
I also remember seeing teams of people walking the streets at all hours wiping down poles and cleaning public benches.
But what does the evidence actually say about surface transmission more than 12 months into this pandemic?
Before addressing this, we need to define the question we’re asking. The key question isn’t whether surface transmission is possible, or whether it can occur in the real world — it almost certainly can.
The real question is: what is the extent of the role of surface contact in the transmission of the virus? That is, what is the likelihood of catching COVID via a surface, as opposed to other methods of transmission?
The evidence is minimal
There’s little evidence that surface transmission is a common way in which the coronavirus is spread. The main way it’s spread is by the air, either by larger droplets via close contact, or by smaller droplets called aerosols. As a side note, the relative role these two routes play in transmission is probably a much more interesting and important question to clarify from a public health perspective.
As he described, one of the drivers for the exaggerated perception of the risk of surface transmission was the publication of a numberof studies showing SARS-CoV-2 viral particles could be detected for long periods of time on various surfaces.
You probably saw these studies because they received enormous publicity worldwide and I remember doing numerous interviews in which I had to explain what these findings actually meant.
The key issue is that as a general principal the time required for a population of microoganisms to die is directly proportional to the size of that population. This means the greater the amount of virus deposited on a surface, the longer you will find viable viral particles on that surface.
So in terms of designing experiments that are relevant to public health, one of the more important variables in these studies is the amount of virus deposited on a surface — and the extent to which this approximates what would happen in the real world.
If you understand this, it becomes apparent that a number of these virus survival studies stacked the odds of detecting viable virus by depositing large amounts of virus on surfaces far in excess of what would be reasonably expected to be found in the real world. What’s more, some of these studies customised conditions that would extend the life of viral particles, such as adjusting humidity and excluding natural light.
Although there was nothing wrong with the science here, it was the real world relevance and the interpretation that was amiss at times. It’s notable that other studies which more closely replicated real world scenarios found lessimpressive survival times for three other human coronaviruses (including SARS).
It’s important to note we’re relying on indirect evidence in assessing the role of surface transmission for the coronavirus. That is, you can’t actually do an ethical scientific experiment that confirms the role surface transmission plays because you’d have to deliberately infect people. Despite being such a seemingly straightforward question, it’s surprisingly difficult to determine the relative importance of the various transmission pathways for this virus.
What we have to do instead is look at all of the evidence we do have and see what it’s telling us, including case studies describing transmission events. And if we do this, there isn’ta lot out there to support surface transmission being of major importance in the spread of COVID.
We could save a lot of time and money
We need to put the risks of exposure to SARS-CoV-2 via the various modes of transmission into perspective, so we focus our limited energy and resources on the right things.
This isn’t to say surface transmission isn’t possible and that it doesn’t pose a risk in certain situations, or that we should disregard it completely. But, we should acknowledge the threat surface transmission poses is relatively small.
We can therefore mitigate this relatively small risk by continuing to focus on hand hygiene and ensuring cleaning protocols are more in keeping with the risk of surface transmission.
In doing this, we can potentially save millions of dollars being spent on obsessive cleaning practices. These are probably providing little or no benefit and being done solely because they’re easy to do and provide the reassurance of doing something, thereby relieving some of our anxieties.
As I write, I am in hotel quarantine in Sydney, after returning from Wuhan, China. There, I was the Australian representative on the international World Health Organization’s (WHO) investigation into the origins of the SARS-CoV-2 virus.
Much has been said of the politics surrounding the mission to investigate the viral origins of COVID-19. So it’s easy to forget that behind these investigations are real people.
As part of the mission, we met the man who, on December 8, 2019, was the first confirmed COVID-19 case; he’s since recovered. We met the husband of a doctor who died of COVID-19 and left behind a young child. We met the doctors who worked in the Wuhan hospitals treating those early COVID-19 cases, and learned what happened to them and their colleagues. We witnessed the impact of COVID-19 on many individuals and communities, affected so early in the pandemic, when we didn’t know much about the virus, how it spreads, how to treat COVID-19, or its impacts.
We talked to our Chinese counterparts — scientists, epidemiologists, doctors — over the four weeks the WHO mission was in China. We were in meetings with them for up to 15 hours a day, so we became colleagues, even friends. This allowed us to build respect and trust in a way you couldn’t necessarily do via Zoom or email.
Animal origins, but not necessarily at the Wuhan markets
It was in Wuhan, in central China, that the virus, now called SARS-CoV-2, emerged in December 2019, unleashing the greatest infectious disease outbreak since the 1918-19 influenza pandemic.
Our investigations concluded the virus was most likely of animal origin. It probably crossed over to humans from bats, via an as-yet-unknown intermediary animal, at an unknown location. Such “zoonotic” diseases have triggered pandemics before. But we are still working to confirm the exact chain of events that led to the current pandemic. Sampling of bats in Hubei province and wildlife across China has revealed no SARS-CoV-2 to date.
We visited the now-closed Wuhan wet market which, in the early days of the pandemic, was blamed as the source of the virus. Some stalls at the market sold “domesticated” wildlife products. These are animals raised for food, such as bamboo rats, civets and ferret badgers. There is also evidence some domesticated wildlife may be susceptible to SARS-CoV-2. However, none of the animal products sampled after the market’s closure tested positive for SARS-CoV-2.
We also know not all of those first 174 early COVID-19 cases visited the market, including the man who was diagnosed in December 2019 with the earliest onset date.
However, when we visited the closed market, it’s easy to see how an infection might have spread there. When it was open, there would have been around 10,000 people visiting a day, in close proximity, with poor ventilation and drainage.
There’s also genetic evidence generated during the mission for a transmission cluster there. Viral sequences from several of the market cases were identical, suggesting a transmission cluster. However, there was some diversity in other viral sequences, implying other unknown or unsampled chains of transmission.
A summary of modelling studies of the time to the most recent common ancestor of SARS-CoV-2 sequences estimated the start of the pandemic between mid-November and early December. There are also publications suggesting SARS-CoV-2 circulation in various countries earlier than the first case in Wuhan, although these require confirmation.
The market in Wuhan, in the end, was more of an amplifying event rather than necessarily a true ground zero. So we need to look elsewhere for the viral origins.
Frozen or refrigerated food not ruled out in the spread
Then there was the “cold chain” hypothesis. This is the idea the virus might have originated from elsewhere via the farming, catching, processing, transporting, refrigeration or freezing of food. Was that food ice cream, fish, wildlife meat? We don’t know. It’s unproven that this triggered the origin of the virus itself. But to what extent did it contribute to its spread? Again, we don’t know.
Several “cold chain” products present in the Wuhan market were not tested for the virus. Environmental sampling in the market showed viral surface contamination. This may indicate the introduction of SARS-CoV-2 through infected people, or contaminated animal products and “cold chain” products. Investigation of “cold chain” products and virus survival at low temperatures is still underway.
The most politically sensitive option we looked at was the virus escaping from a laboratory. We concluded this was extremely unlikely.
We visited the Wuhan Institute of Virology, which is an impressive research facility, and looks to be run well, with due regard to staff health.
We spoke to the scientists there. We heard that scientists’ blood samples, which are routinely taken and stored, were tested for signs they had been infected. No evidence of antibodies to the coronavirus was found. We looked at their biosecurity audits. No evidence.
We looked at the closest virus to SARS-CoV-2 they were working on — the virus RaTG13 — which had been detected in caves in southern China where some miners had died seven years previously.
But all the scientists had was a genetic sequence for this virus. They hadn’t managed to grow it in culture. While viruses certainly do escape from laboratories, this is rare. So, we concluded it was extremely unlikely this had happened in Wuhan.
When I say “we”, the mission was a joint exercise between the WHO and the Chinese health commission. In all, there were 17 Chinese and ten international experts, plus seven other experts and support staff from various agencies. We looked at the clinical epidemiology (how COVID-19 spread among people), the molecular epidemiology (the genetic makeup of the virus and its spread), and the role of animals and the environment.
The clinical epidemiology group alone looked at China’s records of 76,000 episodes from more than 200 institutions of anything that could have resembled COVID-19 — such as influenza-like illnesses, pneumonia and other respiratory illnesses. They found no clear evidence of substantial circulation of COVID-19 in Wuhan during the latter part of 2019 before the first case.
Where to now?
Our mission to China was only phase one. We are due to publish our official report in the coming weeks. Investigators will also look further afield for data, to investigate evidence the virus was circulating in Europe, for instance, earlier in 2019. Investigators will continue to test wildlife and other animals in the region for signs of the virus. And we’ll continue to learn from our experiences to improve how we investigate the next pandemic.
Irrespective of the origins of the virus, individual people with the disease are at the beginning of the epidemiology data points, sequences and numbers. The long-term physical and psychological effects — the tragedy and anxiety — will be felt in Wuhan, and elsewhere, for decades to come.
Liberal maverick Craig Kelly has defected to the crossbench, giving Prime Minister Scott Morrison no warning before his surprise announcement to Tuesday’s Coalition parties meeting.
Kelly, who strongly promotes alternative, unproven treatments for COVID said: “If I’m to speak out and to use my voice the best I can, this is the best decision for myself and for the people that I represent.”
Morrison recently dressed down Kelly in an attempt to stop him making comments that could harm the government’s campaign to get maximum take-up of the COVID vaccines.
His move takes away the Coalition working majority on the floor of the House of Representatives – it reduces the government to a one-seat majority, including the speaker’s casting vote. But Kelly said he would support the government on supply and confidence and indicated he did not see anything on its agenda that “I’m going to be objecting to strenuously”.
The member for the Sydney seat of Hughes since 2010, Kelly was considered almost certain to lose Liberal preselection, with a grassroots movement mobilising against him. He was saved from preselection challenges by interventions from Malcolm Turnbull before the 2016 election, and Morrison in the run up to the 2019 election.
Kelly told Sky: “I believe one of the greatest mistakes that’s been made in this country and also the world was prohibiting doctors from prescribing ivermectin and also hydroxychloroquine.
“I believe this was a terrible error.”
He denied he was an anti-vaxxer, which he said was just a “slanderous smear”.
“I support the vaccine program, but in concert, to use the words of our highest credential immunologist, these other treatments should be used in concert with the vaccine.”
He said he had an “obligation” to act on his conscience.
Morrison told a news conference he had learned of Kelly’s action “at the same time he announced it to the party room”.
“We had a discussion a couple of weeks ago.
“I set out some very clear standards and he made some commitments that I expected to be followed through on,” Morrison said.
“He no longer felt that he could meet those commitments and, as a result, he’s made his decision today.
“By his own explanation [in the party room], he has said that his actions were slowing the government down and he believed the best way for him to proceed was to remove himself from the party room and provide the otherwise support to the government so it could continue to function as it so successfully has, which he says is something he remains committed to. So I would expect him to conduct himself in that way.”
Asked at his news conference about one of Kelly’s staff, who is under police investigation for alleged inappropriate conduct towards a young woman in the workplace, Morrison said he had long held concerns about the staffer and Kelly had long known “what my expectations were about how he would deal with that matter.”
The staffer denies the accusations. Kelly has previously defended keeping the staffer on.
Later in parliament, when the opposition asked about Kelly’s staffer, Morrison accused it of “wilfully conflating two different matters”.
“There is the long-held concerns that I have had about the performance of a staff member in the member for Hughes’ office. That is based on the fact that my electorate adjoins that of the member for Hughes and they relate to performance measures that don’t relate to the more sensitive issues that have come up more recently.
“When it was drawn to my attention, I drew them to the attention of the member for Hughes when we met together several weeks ago. He undertook to take certain actions in relation to that staff member. That was not followed through on.”
With less than three weeks left until the March 13 Western Australian election, the latest Newspoll gives Labor a 68-32 lead, two-party-preferred. If replicated on election day, this would be a 12.5% swing to Labor from the 2017 election two party result.
Analyst Kevin Bonham describes the Newspoll result as “scarcely processable” and says it is the most lopsided result in Newspoll history for any state or federally.
Primary votes were 59% for Labor, up from 42.2% at the 2017 election, 23% for the Liberals (down from 31.2% in 2017), 2% National (5.4%), 8% Greens (8.9%) and 3% One Nation (4.9%). This poll was conducted February 12-18 from a sample of 1,034.
Premier Mark McGowan had an 88% satisfied rating with 10% dissatisfied (net +78), while Liberal opposition leader Zak Kirkup was at 29% satisfied, 41% dissatisfied (net -12). McGowan led Kirkup as “better premier” by a crushing 83 to 10.
A pandemic boost?
Other recent polls have been strong, albeit less spectacular for Labor. Bonham refers to a January 30 uComms poll that gave Labor a 61-39 lead, from primary votes of 46.8% Labor, 27.5% Liberal, 5.1% National, 8.3% Greens and 6.9% One Nation.
There is also a pattern here. Since the pandemic began, governments that have managed to keep COVID cases down have been rewarded. This includes Queensland and New Zealand Labo(u)r governments at their respective October elections last year.
McGowan’s imposition of a hard WA border to restrict COVID has boosted both his and Labor’s popularity. There have been relatively few WA COVID cases, and life has been comparably normal with the exception of a five-day lockdown in early February.
Upper house a different story
But it’s not all good news for McGowan. While Labor will easily win a majority in the lower house, it will be much harder for the ALP and the Greens to win an upper house majority. The upper house suffers from both a high degree of rural malapportionment (where there are relatively fewer voters per member) and group ticket voting.
Group ticket voting, in which parties direct the preferences of their voters, was abolished in the federal Senate before the 2016 election, but continues to blight elections in both Victoria and WA.
There are six WA upper house regions that each return six members, so a quota is one-seventh of the vote, or 14.3%. While Perth has 79% of the overall WA population, it receives just half of upper house seats.
There is also malapportionment in non-metropolian regions. According to the ABC’s election guide, the south west region has 14% of enrolled voters, the heavily anti-Labor agricultural region has just 6% of voters and the mining and pastoral region 4%. All regions return six members.
Despite the convincing lower house win in 2017, Labor and the Greens combined won 18 of the 36 upper house seats, one short of a majority. Bonham notes if the Newspoll swings were replicated uniformly in the upper house, Labor would win 19 of the 36 seats in its own right on filled quotas without needing preferences.
But group ticket voting and malapportionment could see Labor and the Greens fall short of an upper house majority again if Labor’s win is more like the uComms poll than Newspoll.
Federal Newspoll still tied at 50-50
This week’s federal Newspoll, conducted February 17-20 from a sample of 1,504, had the two party preferred tied at 50-50, the same as three weeks ago. Primary votes were 42% Coalition (steady), 37% Labor (up one), 10% Greens (steady) and 3% One Nation (steady).
Of those polled, 64% were satisfied with Prime Minister Scott Morrison’s performance (up one), and 32% were dissatisfied (down one), for a net approval of +32. Labor leader Anthony Albanese dropped five points on net approval to -7. Morrison led Albanese by 61-26 as better prime minister (compared to 57-29 three weeks ago).
During the last week, there has been much media attention on the rape allegations made by former Liberal staffer Brittany Higgins against an unnamed colleague.
However, it appears the general electorate perceives this issue as being unimportant compared to the COVID crisis. Albanese’s ratings may have suffered owing to the perception that Labor has focussed too much and being too negative on an “unimportant” issue.
Despite Morrison’s continued strong approval ratings and the slump for Albanese, the most important measure — voting intentions — is tied. Since the start of the COVID crisis, there has been a continued discrepancy between voting intentions based off Morrison’s ratings and actual voting intentions.
Newspoll is not alone in showing a close race on voting intentions or strong ratings for Morrison. A Morgan poll, conducted in early to mid February, gave Labor a 50.5-49.5 lead. Last week’s Essential poll gave Morrison a 65-28 approval rating (net +37).
Labor bump in Craig Kelly’s seat
As reported in The Guardian, a uComms robopoll in controversial Liberal MP Craig Kelly’s seat of Hughes has Kelly leading by 55-45. This is about a 5% swing to Labor from the 2019 election result.
The poll was conducted February 18 from a sample of 683 for the community group Hughes Deserves Better.
While additional questions are often skewed in favour of the position of the group commissioning uComms polls, voting intention questions are always asked first. However, individual seat polls have been unreliable in Australia.
This is an edited extract of an essay in the latest issue of Australian Foreign Affairs, The March of Autocracy, published today.
It is the year 2049. China is celebrating having reached its second centenary goal – to become a “prosperous, powerful, democratic, civilised and harmonious socialist modernised country” by the 100th anniversary of the people’s republic.
Its economy is three times the size of the United States’, as the International Monetary Fund predicted back in the 2010s. The US remains wealthy and powerful – it has functioning alliances in Europe – but its pacts with Asian allies have fallen into disrepair.
For decades, Hong Kong has been accepted as just another province of China. Few dare to criticise the ongoing human rights abuses there, or in Xinjiang and elsewhere, because of the extraterritorial application of China’s national security laws. Taiwan, if not annexed, is isolated, with no diplomatic partners.
The legacy of Xi Jinping, who led China for more than 30 years, monopolises ideological discourse in China. His successors rule under his shadow.
Outside China, many of the third-wave democracies that transitioned in the second half of the 20th century have become far less liberal. Elections are held, but increasingly authoritarian governments have adopted many of Beijing’s technological and legal tools to manage markets and control politics. The internet is heavily censored.
Mistrust permeates every aspect of China’s relations with the West. International co-operation on climate change and the strong carbon-reduction commitments of the early 2020s have long been abandoned. The focus is on individual adaptation.
Australia remains a liberal democracy and a staunch defender of free markets and human rights. But these are no longer the default standards of global governance – they are minority positions associated mostly with Western traditions. No longer a top-20 economic or military power, Australia’s opportunities to make its mark internationally are few and far between.
An unsettling but plausible vision
This vision of a fragmented and decidedly less liberal international order is highly speculative, but also dispiritingly plausible.
It is unsettling to an Australian reader, not just because Australian foreign policy has been centred on a global set of rules and institutions since 1945, but because Australian identity is so enmeshed with the values of liberal democracy.
The 2017 Foreign Policy White Paper states that Canberra is “a determined advocate of liberal institutions, universal values and human rights”, in stark contrast to Beijing.
All nation states, especially rising powers, desire a favourable global environment in which they can acquire power, prosperity and prestige. The postwar system greatly aided China, and it would be incorrect to claim Beijing wants to dismantle it entirely.
Similarly, it would be disingenuous to overlook the many instances where the US and other liberal democracies have behaved inconsistently.
But the Chinese Communist Party, which leads an authoritarian state, sees the liberal values embedded in the present order as a threat to its rule. Unlike the US, which at times ignores or violates these principles, China needs many of them to be suppressed, even eliminated.
As China seeks to remake the international order, the challenge is to understand where and how Beijing’s efforts will undercut its liberal character, and to identify where it is possible to resist.
How China is changing the world
Rather than upend the existing international system, Beijing’s approach today is to co-opt, ignore and selectively exploit institutions.
Xi has said:
reforming and improving the current international system do not mean completely replacing it, but rather advancing it in a direction that is more just and reasonable.
In late 2019, for instance, the World Trade Organisation’s appellate body ceased to function after the US – complaining about the organisation’s soft stance on China – blocked the appointment of replacement judges.
In many ways, the WTO’s structure is the epitome of a liberal rules-based system: countries relinquish some sovereignty and are bound by judicial decisions in the interests of resolving trade disputes.
In response, China joined with the European Union, Australia and other governments to set up a parallel stop-gap legal mechanism.
This was a reflection of the CCP’s nuanced relationship with the liberal international order. China needs a stable trading system and will agree to binding rules to preserve it. The odd trade dispute does not substantially threaten China’s ideological security.
In the future, Beijing should be expected to exert its influence on the current order. The challenge for states such as Australia is to identify when Beijing’s behaviour exceeds influence and begins to erode the system’s liberal foundations.
China is already skilfully manoeuvring within international institutions to guide their operations, press for reforms and promote the China model.
China also elevates its government-organised NGOs, presenting an image of independence while drowning out the voices of independent civil society.
The China Society for Human Rights Studies, for example, has official consultative status at the United Nations as an NGO, but is co-located with Chinese government offices and staffed by Chinese government officials. It has vigorously prosecuted China’s human rights agenda.
The use of deft diplomacy and inducements to generate voting blocs is unsurprising. But China also seeks to change the system, diluting the liberal elements that threaten the China model and thus the CCP’s rule.
For instance, China has already succeeded in weakening the liberal character of international human rights. In 2017, it proposed its first-ever resolution to the UN Human Rights Council, headed: “The contribution of development to the enjoyment of all human rights”.
It prioritised economic development above civil and political rights, and put the primacy of the state above the rights of the individual. Despite objections and nay votes from Western members, the resolution passed. The subsequent report by the council’s advisory committee, a body of 18 experts supposed to maintain independence, referred mainly to Chinese party-state documents.
Chinese diplomats also block human rights resolutions at the UN Security Council, such as a February 2020 resolution on the plight of Myanmar’s ethnic Rohingya.
While the US has arguably been similarly obstructive on resolutions about Palestine, it is for the narrow purpose of protecting an ally, rather than the broader project of weakening the rights themselves.
China has even been able to marshal the international system to defend and commend its behaviour in Xinjiang and Hong Kong.
In 2020, at the 44th session of the UN Human Rights Council, a joint statement signed by 27 countries, including Australia, expressed concern at arbitrary detention, widespread surveillance and restrictions in Xinjiang and the national security legislation in Hong Kong.
A competing statement supporting the Hong Kong legislation received support from 53 states, only three of which are considered “free” by the non-governmental organisation Freedom House.
By working within the system to rally a voting bloc, Beijing was able to compromise the world’s peak human rights body. Tactics that have been successful in watering down human rights are now being employed in areas where norms are still being established, such as internet governance.
Preparing for the new world disorder
The history of liberal internationalism is replete with contradictions. Some say that in recent decades it is Washington, not Beijing, that has damaged the order most.
So can China really do more damage to an order already on life support? Liberalism is not just facing an external challenge, but one from within.
The answer requires optimism about liberalism’s capacity to self-correct across the arc of history, and scepticism that illiberalism can do likewise. As much as Donald Trump belittled, criticised and attacked America’s institutions, he also created the conditions for a course correction – Joe Biden’s victory.
The CCP is a well-resourced and well-organised political force. It has the potential to be far more effective than any iconoclastic but capricious populist in permanently weakening the liberal foundations of the global order. Much of China’s influence abroad is unavoidable. A rising power with the economic and military strength that China wields is unlikely to be deterred.
On this logic, optimism has no place. But it would also be mistaken to adopt a fatalistic approach. Instead, Australia and its partners must focus their efforts on those elements of the liberal order most worth preserving and most under threat.
The centenary of the people’s republic is still 28 years away.
Australia’s keenly awaited COVID vaccine rollout begins today, with the ultimate goal of vaccinating all Australians by October.
Here are the answers to some key questions.
Can I choose which vaccine I get?
No, there won’t be a choice for the average person. The current initial rollout of the Pfizer vaccine isn’t enough doses to vaccinate all of Australia. So the first people vaccinated with the Pfizer vaccine will be frontline health-care workers, including aged care and hotel quarantine officers.
The AstraZeneca vaccine will be produced for the general public. It’s hoped that will be rolled out during March.
I can’t say how the logistics will run — that’s up to the government, presumably on a state-by-state basis. Most likely they will try to prioritise the highest-risk groups such as the elderly and people with chronic health conditions.
For most people it will be a case of waiting for further announcements as to when enough vaccine is available and it’s appropriate to make an appointment. Children are unlikely to be included in the vaccination program.
How will I be monitored for side-effects?
As doctors, when we vaccinate people we generally like to look after them for about 15-30 minutes, just to check they haven’t had an adverse reaction. That should be the practice for the COVID jab, just the same as for any vaccine.
For those 15-30 minutes you will generally just be sitting in a waiting area at the clinic. You will be monitored to see if you develop any symptoms such as hives or a rash, or wheezing. In those cases you would be monitored even more carefully and staff would take your blood pressure and pulse rate.
If you experience any symptoms once you’ve gone home, it would be up to you to contact your local doctor. Obviously, when trying to vaccinate 25 million people, health authorities can’t follow up with every individual. It’s very much up to them to follow up with whoever gave them the vaccine — whether their GP clinic or other health service.
Should I still have the vaccine if I have an allergy?
That needs to be a conversation between individuals and their doctor, who can advise on a case-by-case basis. But, generally speaking, there are no common allergies that should stop you having a COVID vaccine. If someone has a peanut allergy they can have the vaccine, and the same goes for shellfish, wheat, eggs or any other common allergies.
Some people are allergic to an ingredient called polyethylene glycol, or PEG, which is found in more than 1,000 different medications and is used in the Pfizer vaccine as a mechanism to help deliver the viral mRNA (genetic material) into your cells. In the US and UK vaccine rollouts, a very small proportion of people seemed to have an allergy to this compound: with a million doses you might see about ten people have this allergic reaction. It is rare, albeit less rare than allergic reactions to influenza vaccines.
But no one has yet died from being vaccinated against COVID, so these cases are being captured effectively and are generally detected within the initial observation period of 15-30 minutes. Severe reactions can be treated with an epipen; less severe cases are just monitored.
People might already know they’re allergic to PEG and they shouldn’t receive the Pfizer vaccine, but if they don’t know, there’s no way of knowing that in advance.
The Oxford/AstraZeneca vaccine doesn’t contain PEG. It contains a related compound called polysorbate, which appears not to trigger the same allergy. If you have a known allergy to PEG you would probably be given the AstraZeneca vaccine.
It’s important to stress that these compounds are not preservatives — they are mechanisms to deliver the vaccines effectively.
Will I be fully protected? Do I still need to follow COVID restrictions?
The two vaccines have different efficacy rates — 95% for Pfizer, 62% for AstraZeneca — but these refer to their ability to prevent infection rather than disease. The fact is both are very good at preventing serious disease.
This means that, although you may still have a chance of being infected, you are much less likely to develop severe symptoms, and therefore less likely to infect others. Someone with severe COVID might be coughing and spluttering and spreading the virus more easily, while someone without symptoms might not.
Bear in mind there are two main reasons for the vaccine rollout. The first is to protect members of the public from getting very ill or dying.
The second aim is to provide a degree of immunity in the general population that will ultimately stop the virus circulating.
Of course, this second goal is much harder, which is why it’s still important that we follow any and all COVID precautions. But the hope is that over time we’ll see fewer and fewer people who are COVID-positive, and the risk of spread will fall.
Will the vaccine last forever or will I need to be revaccinated in future?
The current COVID vaccines require two doses, several weeks apart. It’s very tricky to say how long the resulting immunity will last, because globally we have only had these vaccines in use since December or so. It’s possible the immunity might last a year or longer, but at the moment it’s unclear. People might well have to be revaccinated at some stage.
We’ll start to get that data soon though. In fact we should have plenty more information by the time the AstraZeneca vaccine starts to be administered in high numbers in Australia around June or July.
Will the vaccines work against mutant coronavirus strains?
In the fullness of time I expect we’ll start to see “escaped mutant” variants of the coronavirus that can evade the vaccine or make it less effective.
To an extent that’s happened already — the AstraZeneca vaccine looks to be less effective against the South African variant than against the other current variants. Having said that, although it’s not as effective at preventing infection, it still probably has a good chance of stopping you getting seriously sick.
Because we’re not vaccinating everyone in the world, there will always be a pool of people who can incubate new viral strains, potentially giving rise to new mutant variants.
There’s no doubt the vaccines will need to be updated from time to time to deal with this.
Thankfully this process will be relatively straightforward. mRNA vaccines such as Pfizer’s can be tweaked very quickly – virtually overnight – to accommodate new mutants. It’s a bit trickier with non-mRNA vaccines such as the AstraZeneca and Chinese vaccines, but it can still be done.
Will the vaccine rollout mean no more lockdowns?
The vaccine rollout should give us a much firmer handle on the spread of the virus. We can hope to stop seeing hotel quarantine workers being infected and spreading the virus outside, which is what has prompted the recent snap lockdowns in various Australian cities.
As for whether we’ll ever find ourselves in lockdown again, well, we’ll just have to wait and see. But if we’re still persisting with hotel quarantine and hosting arrivals from overseas, the vaccine program will hopefully mean we can afford to be much more liberal with opening our borders without fear that the virus will run rife.
Craig Kelly’s jump to the crossbench leaves Scott Morrison’s government looking like the man who suddenly finds his jacket feels a little thin in the wind.
It still has a majority, but not a comfortable one.
The Coalition’s block of 76 in a House of Representatives of 151 members means it does not possess a working majority on the floor. A vote would be tied if Labor and all crossbenchers opposed it.
Its majority of one includes the Speaker, Tony Smith. He has a casting vote in the event of a tie – one that he would exercise in a procedurally conservative manner, to preserve the status quo.
The Coalition’s position is not like that of late 2018, when it fell into minority government as things unravelled after the overthrow of Malcolm Turnbull.
But losing a number makes descent into minority more of a possibility – if some unforeseen event took out another government MP. That would put it at greater risk of losing votes.
Kelly has said that, beyond supporting the government on confidence and supply, he will back it on the program it took to the election.
This gives him room to play up on a few measures, if he feels inclined, for example on any legislation relating to climate.
On the other hand, he would be unlikely to find parliamentary bedfellows on his pet issues.
Given the makeup of the crossbench, the government can be confident of its numbers, even if they’ve become a little more precarious.
Rebel Nationals would love to recruit Kelly to their party, to get an extra vote in the cause of removing Michael McCormack from the leadership. But Kelly sees himself as an “independent Liberal”; anyway, he’d have nothing to gain by joining the Nationals (which of course would restore the Coalition numbers).
The government is determined to portray Kelly’s departure in the most positive light it can find. “Good riddance”, is the official informal line.
With his passion for spruiking ivermectin and hydroxychloroquine, unproven treatments for COVID, Kelly has been deeply irritating for Morrison. The Prime Minister recently called him into his office for a dressing down, after Kelly’s spectacular corridor clash with Tanya Plibersek.
He wanted Kelly to shut up. Instead Kelly, the zealot with the contrarian cause, is now more than ever on a mission to promote those controversial drugs.
This is the second defector to catch Morrison on the hop.
In 2018 word came of Julia Banks’ desertion when she was on her feet in the House of Representatives. Morrison was giving a news conference at the time.
Kelly on Tuesday only showed his hand in the party room. He said he wanted to tell his colleagues first. But perhaps there was a touch of tit for tat after that bawling out.
For Kelly’s part, he had the choice of an attention-grabbing exit from the Liberal party, or being dispatched from his seat by the preselectors, who would have ensured he’d not be the Liberal candidate at the election.
What harm can Kelly do the government do now?
He can cast an anti government vote now and then.
He can shout his views on COVID treatments and climate change. But he’s done that often enough. Arguably, at least in the mainstream outlets, when he is not talking as a rebel Liberal, what he says on COVID will get less attention. He’ll just be one crossbench voice.
He is signalling he is likely to run as an independent at the election. If he does, he wouldn’t poll well and it’s doubtful his presence would do much harm to the Liberals in his Sydney seat of Hughes.
In what’s a painful fortnight for the government, an element of the Kelly story fed into its problems with handling allegations of rape and sexual misconduct.
A staffer in Kelly’s office, Frank Zumbo, is being investigated over claims of inappropriate behaviour in the workplace (which he denies).
When this matter was raised with Morrison’s office last year by a local reporter via email, it did not answer her.
Morrison on Tuesday said he had spoken to Kelly about both this matter and the staffer’s performance. But Kelly has kept the man on.
The government had a significant win on Tuesday when Facebook agreed, in a deal involving the Coalition making some changes to its legislation, to lift its ban on republishing news on its Australian site.
Any other time, that would have made it a very good day.
Defence Minister Linda Reynolds, who has been under sustained pressure over her 2019 handling of the Brittany Higgins’ rape allegation, entered hospital in Canberra on Wednesday morning.
A statement from her office said she “will take a period of medical leave.
“This follows advice from her cardiologist relating to a pre-existing medical condition.” The statement said the hospitalisation was “a precautionary measure”.
Reynolds had been due to address the National Press Club on Wednesday, the same day Higgins is due to lodge her formal complaint with police against the alleged perpetrator of the assault against her, which she says took place in Reynolds’ office in March 2019.
As Australia’s COVID-19 vaccine rollout begins this week, many people still have questions about the safety of COVID-19 vaccines, both in the short and long term.
As vaccine experts, we hear these concerns all the time, and it’s normal to have questions about a vaccine.
The good news is that scientists have already been testing COVID-19 vaccines for months. For starters, serious side-effects are very, very rare. And, together with what we know about previous vaccines, if side-effects are going to occur, they usually happen within a few months after getting a vaccine. This is why international medical regulators, including Australia’s Therapeutic Goods Administration (TGA), require the first few months of safety data before approving new vaccines. This, plus information coming from vaccine recipients in the northern hemisphere, gives us confidence that COVID-19 vaccines are safe.
In fact, most side-effects occur within the first one or two days. And most of these are minor, such as pain at the injection site, fatigue or fever — which are signs your immune system is building a response against the thing you’ve been vaccinated against.
What do we know about long-term side effects?
Since December, more than 200 million people have received at least one dose of a COVID-19 vaccine worldwide — more than the total number of people who have been infected with the virus (112 million).
Given the sheer number of vaccines administered to date, common, uncommon and rare side-effects would have been detected by now. What’s more, we’ve been testing these vaccines in clinical trials since mid-2020, and both the Pfizer and AstraZeneca vaccines have shown excellent safety results.
This gives us confidence the vaccines that’ll be used around Australia are safe.
We’ve also seen some people raise concerns online about mRNA vaccines, such as the Pfizer-BioNTech vaccine, being a “new” technology. mRNA (or “messenger” RNA) is found in all living cells. mRNA is a message that tells cells how to make proteins that trigger the immune response inside the body. That immune response is what protects against infection if an individual is exposed to the virus. mRNA is not the same as DNA (your genes), and it cannot combine with our DNA to change our genetic code. mRNA vaccines do not affect or interact with DNA in any way. So we can be assured there’ll be no long-term DNA-altering effects from these vaccines.
What’s more, checking the safety of the vaccines doesn’t just stop after they’ve been registered for use. Once a vaccine has been introduced, ongoing monitoring of its safety is a crucial part of the vaccine development process.
Australia has a robust system for this ongoing monitoring. The system was established to detect any unexpected side-effects from vaccines (if they occur) and ensure they’re investigated promptly. This type of monitoring is standard practise in Australia for vaccines. The data about COVID-19 vaccination collected in these surveillance systems will be published weekly on the TGA website. This should reassure Australians that if there’s a new serious side-effect, we will know about it, communicate it, and act on it quickly.
Withdrawal of vaccines after introduction to the general population is a very rare event.
In the United States, a rotavirus vaccine called Rotashield led to a small increase in the number of small intestinal blockages. This prompted its withdrawal in the late 1990s. In Australia, an increased risk of febrile seizures in young children following a specific influenza vaccine was identified in 2010. It was subsequently withdrawn from use in that age group, and we now vaccinate with a different, safer flu vaccine. This vaccine is no longer available in Australia, and has been subsequently reformulated.
Both of these side-effects were observed within weeks of vaccination.
We now have improved monitoring systems in Australia to detect such serious side-effects even sooner, in the general population after clinical trials, than we did a decade ago.
But what about short-term side-effects?
Pfizer-BioNTech COVID-19 vaccine
The expected side-effects of the Pfizer vaccine have been reported from trials involving roughly 43,000 participants aged 16 years and older from the US, Argentina, Brazil and South Africa. Half of the participants received the Pfizer vaccine and half received a placebo. And as part of COVID-19 vaccine rollouts around the world, millions of people have already been given this vaccine since December, meaning we have safety data now from both clinical trials and two months of “real world” vaccination.
For those receiving this vaccine in the large clinical trials which started in July 2020, about 80% have reported pain at the injection site. Other common side-effects included fatigue, headache, muscle pain, chills, joint pain and fever.
These were most often reported one or two days after the day of vaccination, and typically only lasted about one day. While some vaccine recipients may need a day off work due to some of these side-effects, this does not indicate the vaccine is unsafe.
In trials, no difference was seen in the rate of severe side-effects between the Pfizer vaccine and placebo. Early in the US program, 21 cases of anaphylaxis were reported. It’s estimated anaphylaxis occurs at a rate of 11 in every one million recipients (0.0011%) of the Pfizer COVID-19 vaccine. Most occurred within 15 minutes, and all patients recovered. This is why it’s a good idea though to remain at the vaccine clinic for up to 15 minutes after vaccination so that treatment and care can be provided if necessary.
This vaccine has been tested in ongoing trials with around 55,000 participants from the United Kingdom, Brazil, South Africa and the US. About half received the Oxford-AstraZeneca vaccine and half a placebo. Millions of doses have been already been administered among the general population, particularly in the UK.
Data from four clinical trials which commenced in April 2020 in the UK, Brazil and South Africa, show the most common side-effects were pain at the injection site, fatigue, headache and muscle pain. Similar to the Pfizer vaccine, there was no difference in the rate of reported severe side-effects for the vaccine compared with the placebo.
Just 0.7% of participants (79 people) from the four clinical trials who received the Oxford-AstraZeneca vaccine reported a serious side-effect after receiving at least one dose, compared with 0.8% (89 people) of those in the placebo group. No additional safety concerns have been identified since the vaccination program began in the UK.
With countries continuing to monitor those who have received vaccines, we should be reassured there are no major safety concerns detected for serious side-effects so far. With millions of people vaccinated already, our confidence about the safety of COVID-19 vaccines is very high.
In Australia, and internationally, we have robust systems in place to continually monitor vaccine safety, ensuring Australians can be safely afforded the protection that COVID-19 vaccines are designed to provide.
Fifty dollars sounds like a lot. But the increase in the JobSeeker unemployment benefit announced by Prime Minister Morrison on Tuesday is $50 per fortnight, which is just $25 per week. It will replace the temporary Coronavirus Supplement of $75 per week, which is itself well down on the $275 per week it began at in March last year.
It’s hard to see the increase as anything other than a cut, especially when coupled with another change which will allow recipients to earn other income of only $75 per week before JobSeeker gets cut. That’s down from the present $150 per week.
As the prime minister said, it’s better than it would have been if things returned to the level we had before special coronavirus provisions. At that time, recipients could earn only $53 per week before having their payment reduced.
But it’s not particularly generous. The Age and Sydney Morning Herald are quoting senior government sources as saying the $50 per fortnight increase in the rate was the lowest figure the party believed would be palatable to the public.
Morrison justified the increase of $50 per fortnight – rather than $150 (which would have kept what’s left of the coronavirus boost in place) or $100 or any other figure – by saying it will bring the payment to
41.2% of the national minimum wage, which puts us back in the realm of where we had been previously
Taking account of taxes paid and superannuation received by minimum wage workers gives a slightly higher replacement rate of 42.3%. That takes it back to roughly where it was at the end of the Howard government in 2007.
However, there’s no readily apparent reason why that should be a benchmark.
During the life of the Howard government the level of the single payment fell from around 50% of the minimum wage to 42%, meaning what’s proposed will return it to its lowest point relative to other benefits under Howard.
JobSeeker and age pension as a proportion of the minimum wage 1990-2021
Morrison also said the increase was the largest permanent increase in the unemployment benefit since 1986. It’s an increase of 9.7%.
During the Hawke and Keating administrations, the payment increased 23% in real terms. During the Whitlam administration it increased 50%. This means that while what’s offered is substantial by the standards of recent decades, it’s less so in the longer run.
But what about the supplements?
Morrison also argued in his press conference JobSeeker is more adequate than the base rate would suggest because
on top of that, if they’re receiving Commonwealth Rent Assistance, that payment would increase to $760.40; and on top of that, the average value of stand-alone supplements, the energy supplement and so on, is an additional $13.03. So the suggestion that anyone who was on JobSeeker is simply on that payment alone and there aren’t additional supports that are provided is not correct.
It’s true all people on income support receive the energy supplement (included in the figure above). But for a single person on JobSeeker, the supplement is only $8.80 per fortnight or less than 65 cents a day.
Many people do indeed get rent assistance, but after paying rent they become worse off rather than better off.
That’s because to get the maximum rate of rent assistance for a single person of $140 per fortnight (9% of the minimum wage), that person has to be paying around $310 per fortnight in rent. If that person is paying more, they get no extra help. The maximum is also lower for people in shared accommodation.
Private sector renters are amongst the worst off recipients of income support.
Other supplements such as the remote area allowance are indeed available, but are of no help to people who do not live in remote areas and may be inadequate to cover the higher costs involved. Supplements for help with language and literacy are only paid to people in special educational programmes.
Producing an average that includes supplementary payments most people don’t receive is inherently misleading.
How Australia compares
Net replacement rates measure the proportion of previous in-work income that is maintained after several months of unemployment. They are the benchmark used by the the prime minister to compare benefits to the minimum wage.
Using two months in unemployment as the measuring point (and using the most recently published 2019 rankings) before the pandemic, Australia’s replacement rate was the lowest in the OECD — even after rental assistance was added in.
Unemployment benefit, share of previous income after two months
When the maximum rate of Coronavirus Supplement was briefly in force in 2020, Australia moved to around the OECD average.
The new rate from April 2021 will move Australia from the lowest to the second lowest, ahead of Greece only.
Unemployment benefit, share of previous income, after Australian increase
It should be acknowledged Australia’s system is based on different principles to many other OECD countries in which workers and their employers make contributions to and withdrawals from unemployment insurance.
But the difference in philosophy does not change the brutal reality that when Australian workers lose their job, their incomes fall more than in almost any other high income country.
Even after what the government has trumpeted as a historic increase, there will be few developed countries where people will be as worse off after losing work. Any permanent increase is welcome, but there is a long way to go.